Psychosocial Rehabilitation

PEOPLe, Inc. works to incorporate the principles, practices, and promises of Psychosocial Rehabilitation into all of its services. Our goal is and has been to guide people as they learn about, plan, and implement new ways – developing skills and accessing resources – to improve their physical & mental health health, daily living skills, sense of self & purpose, and social connectedness to natural supports & community.

Our Psychosocial Rehabilitation staff are there to assist clients in developing self-directed, strengths-based, and outcomes-focused rehabilitation plans that involve both direct instruction (increasing skills), and direct connections and linkages to community-based services & supports (increasing resources & additional skills). We employ a mobile staff to meet people in all sorts of settings (wherever the client feels most safe & comfortable), and personally join them as they implement their psychosocial rehabilitation plans. Our peer staff build off the foundation of mutuality and empathy, to engage in meaningful ways, strengthen motivations for self-directed change, and ‘teach by experience & example’ that recovery and a better life is indeed attainable. These services follow a wraparound model, including but not limited to exposing people to a full range of community health and wellness resources, assessing daily living skills, directly teaching restorative skills needed to improve daily life, teaching wellness self-management skills, and fostering people’s social integration into community.

Habilitation

Habilitation, we have found, builds off the foundation and strengths of psychosocial rehabilitation by adapting instructional content, methodology, and delivery to meet the appropriate needs of each person. This is primarily accomplished by ‘differentiating’ more general psychosocial rehabilitation instruction into person-specific care plans that wrap additional accommodations around people to ensure they have the intensive services & supports they need to succeed. “Differentiation” is an approach to instruction that advocates active planning for and attention to clients’ differences and diversity in learning styles & abilities. Differentiation in practice can take many forms, including augmenting instruction with unique designs based on clients’ different strengths & capabilities. This aligns with our overall agency mission and core values, since we promote and believe in customized care based on the needs of individuals. Habilitation focuses intensively on activities that strengthen the following skills: cognitive – mental skills (knowledge); affective – growth in feelings or emotional areas (attitude or self); and psychomotor – manual or physical skills (skills).

Short-term Crisis Respites (Rose Houses)

As stated previously, PEOPLe, Inc. currently operates Rose Houses, peer-operated short-term crisis respites. Designed, operated, and staffed by people who have lived through mental health emergencies and used psychiatric emergency services in the past, PEOPLe, Inc’s Rose House model has become a successful alternative to psychiatric hospitalization and other traditional crisis services.

Because of this, the New York State Office of Mental Health (OMH) consulted with PEOPLe, Inc. to craft the language for “short-term crisis respite” services for future HCBS guidelines (compare our manual published by OptumHealth Managed Cared, “Hospital Diversion Services: A Manual on Assisting in the Development of a Respite/Diversion Service in Your Area”).

PEOPLe, Inc.’s Rose Houses are 100% peer-operated short-term crisis respites that are open and accessible 24 hours a day, 7 days a week, 365 days a year. Instead of traditional “treatment,” Rose Houses are safe, empowering, self-determined learning communities that allow guests to work on looking at their crises as constructive opportunities for change. Rose Houses are not only site-based, but also reach out beyond their walls through 24 hour peer-operated warm lines, and mobile peer services.

Rose House is based on a common sense approach to crisis response that: (a) ensures that people feel comfortable and safe – physically, emotionally, psychologically; (b) delivers 5-star customer service that meets and exceeds people’s personal expectations; (c) aligns all behaviors and actions with core values that promote recovery & wellness; (d) uses the mutuality of lived experiences to unleash the world-changing power of storytelling, listening, and dialogue; and (e) helps people to look at their crises differently.

The Rose House model has been quite effective at breaking cycles of crisis and recidivism currently plaguing New York State. Not only do Rose House guests not use the hospital when they’re in crisis, but our 30-day follow-up study shows that over 88% of Rose House guests stay out of the hospital after their stay, and 98% of people attribute that success to the Rose House (N=119).

Empowerment Services – Peer Supports

Although our agency incorporates empowerment services and peer supports into all of its programs, we also operate programs dedicated to peer advocacy & support, serving individuals with behavioral health conditions (mental health, co-occurring) in a diverse range of settings, including but not limited to drop-in Engagement Centers, hospitals, clinics, day treatment programs, and residential care facilities.

Through all of our Empowerment Services and Peer Supports we provide clients with high-quality customer service based on a culture of engagement & wellness, delivering hands-on advocacy services, a diverse range of peer support groups and one-to-one sessions, education in self-help skills, crisis planning & advance directives, systems navigation, peer bridging, and wellness coaching.

Through our Empowerment Services – Peer Supports, staff take action to represent the rights and interests of people living with mental / behavioral health conditions by removing barriers to their recovery and overall wellness, addressing issues of informed choice, access to services, service quality, people’s rights, people needing their basic needs met, and stigma & discrimination.

At our core we use the mutuality of lived experiences to engage with individuals to promote possibilities for positive emotional, psychological, and social development, while also helping them to frame their so-called ‘symptoms within the larger stories of personal experience, trauma, and socio-economic determinants of health.

We also work hard to overcome silos and fragmentation in system layout with direct connections instead of referrals, directly bringing people to the solutions they need.

We are also deeply committed to helping clients to work on their own personal health and wellness goals, to learn about self-help & coping tools/skills, and to plan effectively for crisis (advance directives, WRAP plans).

Additionally our staff embedded in local psych hospital emergency rooms support clients along the full continuum of crisis care, including bridging from hospital to home, and to facilitate ongoing and meaningful engagement with services / resources in the community.

Pre-Vocational Services

A great deal of the people we serve have had much of their adult lives disrupted by mental health and post-traumatic challenges, and sometimes long-term inpatient/institutional living. This has caused large gaps in their employment histories. Because of that, it has always been imperative that our employment counseling program provide Pre-Vocational Services through volunteer work or internships at our agency or other community-based businesses. This gives our clients the ability to learn – hands-on and in integrated settings – about themselves, to develop transferable proficiencies (including both soft & hard skills), to learn how to manage their personal health & wellness in real-life & real-time situations (using OMH’s Wellness Self-Management Program), and to fill in gaps in their resumes.

Intensive Supported Employment

Our agency’s supported employment services are based on the excellent & evidence-based Individual Placement and Support (IPS) model that (a) is entirely client-centered & client-directed; (b) follows an “employment first” philosophy of employment without pre-conditions; (c) integrates benefits counseling into the process to ensure that clients are making comfortable & informed choices about their finances; (d) encourages clients to work in integrated settings (with persons with and without disabilities); (e) helps clients to develop view their employment as part of their overall wellness; (f) never cuts off support; (g) works with employees at the request of clients; and (h) works to get people employed as quickly as possible, according to their preferences & capabilities.

Our Intensive Supported Employment staff break up the larger employment process into smaller manageable chunks, assessing clients on their feelings about their work readiness awareness, job searching abilities, and knowledge of on-the-job duties, responsibilities, and challenges. They then explore where the individuals should ideally begin the processes. This can include initial exploration of themselves, job & career exploration, and developing longer-term education & training goals if needed.

Most of the time though, clients are ready to move rapidly (within 1 month) to the job searching process, as we believe in and encourage securing employment as quickly as possible. This stage involves hands-on education in creating a resume, a cover letter, job searching methods, completing job applications, and job interview skills development.

Concurrently, during the job search process we begin assessing client’s extra-vocational health & wellness needs to assist them in developing whole health plans of action to ensure that all their needs are met as they venture into the labor force.

Ongoing Supported Employment

Our Ongoing Supported Employment services are generally initiated as an extension of our Intensive Supported Employment. Our Ongoing Supported Employment is guided by and strengthened by the fact that we are an agency made up of people with their own stories of illness & disabilities, but more importantly of recovery & re-integration into the workplace. Our agency’s unique perspective and our employees’ unique histories allow us to know intrinsically the types of fears & challenges that often arise in people entering or returning to the workforce, and how to overcome them. This includes everything from benefits advisement, to transportation plans, to addressing workplace issues both on & off the job site, and even supporting clients as they transition into different opportunities within or without their initial place of employment. We ultimately take a two-pronged approach to our Ongoing Supported Employment: (a) directly providing on-the-job support services that address employment & workplace issues; and (b) working as integrators – along with clients and generally their care coordinators / case managers – to ensure that the rest of their health, human, and social service supports are working to their benefit, and ultimately engendering their ability to work.

Our on-site work with clients involves assessing them on and directly assisting them in learning specific job tasks, personal time management, securing reasonable accommodations, handling stress, problem solving, maintaining their wellness, getting along with supervisors & other co-workers, and maintaining concentration, memory, and speed at work. And concurrently, we help clients to manage their overall health & wellness by creating whole health plans of action to ensure that all their needs are met as they participate in the labor force.